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Rhinoplasty is not always for looks; sometimes, patients have functional issues that require surgery to fix. In this case, insurance might cover the cost. This blog discusses the differences between functional and cosmetic rhinoplasty, what may be required to qualify for insurance coverage, and the out-of-pocket costs that may be incurred.
Functional vs. Cosmetic Rhinoplasty
Health insurance companies only cover procedures that are deemed medically necessary, so it’s rare that plastic surgery gets coverage. Certain procedures, like breast reduction and rhinoplasty, are unique in that they can be deemed medically necessary, so sometimes, insurance will intervene.
Functional rhinoplasty is a procedure that alters the shape of the nose primarily to treat breathing issues, medical distress, or trauma. This type of rhinoplasty, if deemed medically necessary for your health and well-being, may be covered by health insurance. Some examples of functional rhinoplasty include:
- Rhinoplasty for sleep apnea or snoring
- Sinus or nasal procedures
- Chronic sinus conditions
- Nasal passage abnormalities
- Deviated septum
Many of these issues are treated with intranasal surgery, typically by widening the nasal passages or removing inflamed tissue.
What If I Have Cosmetic Concerns, Too?
Cosmetic rhinoplasty, on the other hand, is not covered by health insurance because it is elective, not required for your health or quality of life. Cosmetic rhinoplasty can treat the following concerns:
- Bump on the bridge of the nose
- Drooping, upturned, or bulbous nasal tip
- Crooked nose or nostril asymmetry
- Large or wide nose
Rhinoplasty reshapes and resizes the nose, nasal tip, bridge, and nostrils to achieve a result that suits the patient’s face and natural features, creating a more harmonious effect.
So, what if you have both functional and cosmetic concerns? Can your surgeon treat both at once? Absolutely. In fact, it’s very common for patients to address both functional and cosmetic concerns in a single procedure. And in terms of insurance coverage, the insurance provider will cover only the functional aspect (a deviated septum, for example), and the patient is responsible for the cosmetic aspects.
How to Get Insurance to Approve Your Rhinoplasty
Even if you have a clear need for functional rhinoplasty, you and your primary care provider, as well as your plastic surgeon, must work together to compile the proper paperwork and prove your condition to your insurance company.
You and your doctor may be asked to provide documented proof that conservative treatments for your condition, such as nasal spray and CPAP machines, are ineffective and that surgery is a necessary next step. You may be asked to provide the following items showing your nasal condition:
- Medical reports
- Photos
- Records
It’s also important to note that this process should be completed before you undergo surgery, because not all plastic surgeons take insurance.
How Much Does Rhinoplasty Cost in the Bay Area?
If you think you might be a candidate for rhinoplasty and suspect you might not have insurance coverage, you likely want to know how much you can expect to pay. Because plastic surgery is so custom, you’ll likely see varied pricing in your research. However, the average cost of rhinoplasty (without insurance) in the Bay Area and San Francisco ranges from $12,000 to $25,000, with most patients paying between $12,000 and $15,000.
Keep in mind that these prices vary based on several factors, including the complexity of your procedure, the surgical technique required (closed vs. open rhinoplasty), the surgeon’s expertise, and other variables.
Low-Interest Plastic Surgery Financing
Most plastic surgery practices offer financing with third-party lenders like Cherry financing. This makes cosmetic surgery more accessible to more people and opens up more options for patients who do not want to sacrifice cost for safety or satisfactory results.
Dr. Kimberly Henry is the Bay Area’s leading female plastic surgeon, with decades of experience providing stunning, custom results for her patients. She is a strong advocate for her patients and always goes above and beyond, including offering in-house 0% financing.
Interested in Rhinoplasty in San Francisco and the Bay Area?
Learn how Dr. Henry can sculpt a gorgeous nose that complements your features and allows your natural beauty to shine. Whether you need cosmetic, functional, or combination rhinoplasty, Dr. Henry offers surgical excellence and compassionate care in equal measure. Call our office today at (415) 924-1313 or complete the contact form to request a consultation.
